Leading Edge – Maura McCaffrey Takes the Helm at Health New England

Maura McCaffrey remembers reading the want ad in her Sunday paper — Health New England was looking for a clinical pharmacist — and thinking this was a job she really wanted.

She had gotten to know many members of the staff at the Springfield-based health insurance provider while working as a sales representative and then regional account executive for the pharmaceutical giant Eli Lilli, and had come to respect the company’s culture and team-focused way of doing business.

But there were some complications to making this career move. Indeed, McCafferey and her family were living 75 miles east of Springfield at the time. Her twin sons were 4 years old. She had an office in her home, made her own hours, and drove a company car she would have to relinquish.

After some soul searching, though, she decided to apply, with the thinking that this was very likely to be a short-term assignment, a line or two on her resume, and merely the latest example of what she described as a career-long pattern of being able to put personal fears and insecurities aside and take some risks to advance professionally. “My plan was to figure out what I could about managed care, and I thought I would be here 18 months, two years at the most.”

It didn’t work out that way, and she told HCN that she knew this would be the case probably on her first day at HNE. But she didn’t tell her husband that until well after those 18 months she had originally given herself to figure out if this was going to work.

“I told my husband, ‘I have to apply for this job, I have to work at Health New England — this is my opportunity to find out what this company is all about,’” she recalled. “And he said, ‘well, that’s a little impulsive; you just read a newspaper, we live 90 minutes away. You want to take that job and make that commute?’

“I said I thought it would be worth it for 18 months,” she went on. “Three years later, my husband said ‘you’re either all in on this and we’re going to move the family, or you’re going to find something else.’ And I said, ‘I’m all in — I just haven’t finished learning everything I want to learn from Health New England.”

In the decade since, she’s gone from all in to all the way to the top.

Indeed, she recently succeeded Peter Straley as president and CEO, completing a succession process that began heating up over the past several months as Straley let his intention to retire be known, but has actually been a work in progress for several years.

As she talked with HCN about her ascension, one that has quickly made HNE one of the largest women-led business in the region, McCaffrey said the company essentially put her on a path to the CEO’s office, and she took it, along with many more of those risks she described earlier.

There were several changes to the title on the business card along the way — she served as everything from Pharmacy Services manager to vice president of Marketing, Business Development & Medicare to chief executive officer — and that learning process she described earlier never stopped, and it won’t now that she has the corner office, she said.

Looking forward, McCaffrey said there are a number of challenges facing the healthcare industry and payers such as HNE, especially when it comes to controlling the cost of care and, overall, making the community healthier.

These two missions go hand in hand, she said, adding that the industry must somehow move from its current, and highly inefficient, fee-for-service model to one that rewards providers for keeping people from getting sick, not simply treating them when they are.

And one of the keys to progress is inspiring individuals to take responsibility for their own health, she went on.

For this issue, HCN talked at length with McCaffrey about everything from that path she took to the CEO’s office, to the factors that are keeping more women from gaining such a title, to the prospects for real — and effective change — in the business of providing affordable health care.

When it comes to taking control of one’s health, McCaffrey, like her predecessor, practices what she preaches.

She said she’s generally up by 4 each morning and starts her day with exercise, for a minimum of 10 minutes, but usually much more. She’s at her desk by 6 or 6:30 — “that’s my best thinking time” — and quite often, that desk sits three and a half feet in the air.

Indeed, McCaffrey’s workspace includes a desk leaf complete with a small motor that elevates it to a height by which she can work while standing, which, she states, is far more healthy than sitting for eight or 10 hours.

“I sit in meetings all day, which isn’t good for you,” she noted, “so I stand when I’m doing e-mails and other work.”

How McCaffrey, the proud daughter of Irish immigrants who came to this country in the early ’60s, arrived at the CEO’s office with the so-called ‘standing desk’ is an intriguing story, one that begins at an old-fashioned corner drugstore in her hometown of Leominster, roughly 20 miles north of Worcester.

There, after school, she worked the soda fountain, scooped ice cream, served coffee, sold cigarettes and lottery tickets, and, when the pharmacist was busy, would go out back and help him fill prescriptions, usually doing the paper work in this time before computers.

Eventually, the store’s owner tried to convince her to attend pharmacy school — and had to keep on trying, because she was initially, and continually, resistant to that idea.

“I said, ‘are you crazy — how would I ever know all these prescriptions and all this stuff?’” she recalled, adding that the pharmacist eventually tried persuading her by highlighting the job-security aspects of the profession — one has to be licensed to do this work — and when that didn’t work he focused on financial security and schedule flexibility.

“But again I said ‘thanks, but no thanks,’” she went on, adding that he finally sold her when he said she could attend UConn or the University of Rhode Island and pay in-state tuition because Massachusetts didn’t have a public pharmacy school. That was welcome news because she was paying for college herself.

As she was graduating from URI, the pharmacist who started her down this road was selling his five stores to CVS, but he essentially made McCaffrey part of the deal, so she worked for that chain for several years, and thoroughly enjoyed the work.

“I loved every minute of it — it was a phenomenal career,” she told HCN. “You saw when people were getting healthier or better, or they’d share stories about their families — it was a great job and I had a great team to work with.”

Part of that job was to do community support programs, where she would speak on behalf of CVS and talk about the benefit of pharmacists or educate the public about their medications. And in the course of doing so, she became acquainted with people in the pharmaceutical industry, who encouraged her to join them.

Eventually, after being reminded that if this didn’t work out, she could go back to pharmacy work, she did, joining Eli Lilly first as a senior sales representative and then as a regional account executive, handling much of Central and Western Mass. and working with companies like HNE.

And this brings us back to that want-ad she read in the Sunday paper, and the learning that she wanted to continue.

As she talked about her first years with HNE, McCaffrey said there were plenty of learning opportunities, which eventually exposed her to every department in the company, the people who worked in them, and the processes for achieving continuous improvement and growth.

“They allowed me to take on opportunities that were stretch-risk assignments for departments where I had no idea, technically, what they did,” she explained. “But I knew I could work with people and I could help manage people, and we could get to the outcomes. And I also knew that if you gave me time and let me sit down and work with people, I could understand the department and what they were doing.

“One of these was the call center,” she went on, “and later, it was enrollment, provider relations, and credentialing. I didn’t have a strong background in those departments, the people here are team players, but it’s all about collaboration; they’re OK if you’re not the world’s leading expert on call centers — as long as you’re willing to jump in, learn about it, look for opportunities to improve, and take care to develop the people on these teams, which I was.”

Taking full advantage of the opportunities given her, McCaffrey started moving up the ladder, from clinical pharmacist to Pharmacy Services manager to director of Pharmacy & Service Operations to vice president of Pharmacy & Service Operations. Then came another one of the exercises in risk-taking — assuming a new position essentially created for her: vice president of Marketing & Business Development.

“I had some marketing background from Eli Lilly — they put us through great training programs, but I didn’t go to college for marketing,” she explained, adding that she leaned on those who did to help build the HNE brand, while also engaging in business-development initiatives, such as launching the Medicare and Medicaid product lines.

After six years in that role, she was promoted to COO, another newly created position, which included everything she was already doing, in addition to sales and a new IT department.

By the spring of 2013, she found herself spending more and more time at Baystate Health — HNE’s parent company — working with its CEO, Mark Tolosky and board members, and filling in for Straley at a number of meetings and events. Late that summer, not long after Straley made clear his intention to retire and the timeline to do so, Tolosky offered her the CEO’s job. She took over early last month.

Her new office is slightly larger than the one she’s occupied the past few years, and the responsibilities are certainly greater, but McCaffrey said her management style, her approach to working with others within the company won’t change.

When asked to describe it, she returned to that word collaboration, which she described as the opposite of dictating, which is certainly not her style.

“I believe that if you get teams to work together, you get a better product than if just one person is in a dictatorship role,” she said. “But likewise, you can’t be afraid to make decisions; you need someone who can be decisive, and with either limited data or as much data as you have, make those decisions.

“More importantly, my leadership style is based on what we call our high-performance culture,” she went on adding that there are three steps to creating it:

• Making sure employees know and understand that they are responsible for their own performance;

• Likewise, employees are responsible for the success of those who are critical to helping them get their job done, what the company calls ‘shareholders’; and

• Making it clear that employees have to give up their own agendas for the good of the company.

“You need to develop core relationships with the people you work with,” she went on. “To me, that’s the cornerstone of the high-performance culture we have here; you must develop relationships, even with the most challenging people, the people that are most difficult for you, the people who have opposite personalities than you. My expectation is that you will then understand where someone is coming from and empathize, put yourself in their shoes.”

Teamwork and a high-performance culture has enabled HNE to outperform competitors that are exponentially larger, said McCaffrey, and those qualities will be needed moving forward as the landscape for health plans becomes ever more challenging.

Looking ahead, she said that change is necessary — that aforementioned shift from the traditional pay-per-service model to one that rewards providers for keeping people from getting sick — and that it is happening, albeit not as quickly as most people would like.

“If we’re changing the way we practice medicine, from the fee-for-service, do-more-and-you-get-paid-more world, to one of population management and being responsible for a global budget for people, while at all times maintaining the highest-quality care possible … that’s not going to happen overnight,” she said. “But can I look out on Western Massachusetts and see flickers of positive behavior? I absolutely can.”

“But even with continued progress in population management, the real key to creating a healthier community will be to inspire people to take control of their own health and well-being,” said McCaffrey.

“That’s a challenge for every provider that interacts with someone, it’s a challenge for every disease-management group,” she told HCN. “How do you convince someone that wearing a pedometer and walking 10,000 steps a day is really a good thing? They can read the material, they understand that, and they understand that if they eat McDonald’s three times a week, that’s not good for their heart. Moving from knowing something to doing something, or not doing something, is the key.”

Now one of the few women in top-leadership positions among the region’s largest employers, McCaffrey was asked about these numbers and whether they are likely to change.

She said they might, if the business community becomes more willing to give women such opportunities and, more importantly, if women are willing to take the risks and do the hard work necessary to seize those opportunities.

“Women have to be willing to take risks and put themselves out there,” she said, adding that this goes for men as well. “If you want to sit back and hope that someone comes to you someday and says ‘would you like to be a CEO?,’ then the chances of that happening are slim to none.

“But if you’re willing to manage your fears and your insecurities, and say ‘I don’t know how to manage a call center, but I know how to manage people, and if you know how to do that part of a job the technical aspects will take care of themselves,’ then you can get the role you want — there’s no doubt in my mind,” she went on. “You have to be able to put aside those fears and say ‘I can do this.’ You can’t be afraid, you can’t let fear hold you back.”

It’s been a very intriguing 10 years for both the healthcare industry and McCaffrey since she told her husband she was “all in” on Health New England.

She’s shown repeatedly that she’s able to but aside those fears and insecurities she mentioned and not only reach for opportunities, but grasp them as well.

This is a philosophy that she believes permeates the entire company, and she’s intent on keeping it that way, as evidenced by the language in a global e-mail she sent to the staff just after she officially took over as CEO.

“I said that I was excited about what’s in store for us,” she recalled. “I said that there are times of change still ahead, and that if we keep to the core of who and what our company is, we can look at this change as opportunity and growth for the company.”

And as she goes about that assignment, she can certainly lead by example.